Aa
What to do?
I am a male, & in a LT relationship. I received oral sex from a fem. outside of relationship(no other sexual contact). 1 week post-exposure I was have lots of bladder pressure, frequency, urgency, dribbling, passing small amounts of urine. No noticeable discharge, dysuria,etc. I self medicated with cipro figuring this was a reoccurence of prostatitis as I have been previosuly diag. w/boggy prostate and white cells in prostatic secretions. This same day I had vaginal sex with sig. other. Symp did not improve so went to clinic on Tues 2/9, tests for chlam, gc, trich, all neg. A genital culture (swab), came back as "white cells seen", no organism growth.Urine cult. (first catch) reported value leukocytes=small. Treated with azith 1g and 500mg cipro. Ultra sound showed 48 cc resid vol and enlarged prostate-cubic volume-27cm. I was also given cipro 500mg bid/14 days. My SO other was was also treated with 1g azith, 500mg cipro, and 400mg suprax. 1 week later, pressure and frequency improved, clear dicharge upon waking, not later in the day however unless milking to find. Went back to clinic and got 10 days of doxy. I am on 3rd day of doxy as is my SO. Questions 1. I have read most post and responses about normal oral flora causing NGU. I believe this is what was causing my initial symptoms. Am I on the proper treatment? 2. I've read a study that myco. gen. is not found in the throat of CSW in Japan. Can one aquire mycoplasma gen. from oral sex (fellatio)?? 3. I self med(cipro) can I still rely on my GC results at day 9, or is do I need a test for cure, meaning will GC reappear when I am off all meds? 4. I have seen that moxiflox is an alt. for mycoplasma due to resistance. 5. Anx. is really high. Could this all be prostate related again? Could the white blood cells seen in culture be from the prostatitis or should I go more at a mycoplasma or unknown oral flora?6. Does my SO need addtl. eval/meds? Is is safe to resume sex?
MEDICAL PROFESSIONAL
Welcome to the STD forum.
The symptoms you describe do not suggest NGU, for which the main symptom is discharge with little or no painful urination. Your symptoms are much more like a bladder or prostate problem, not urethritis. Conceivably you could have had a viral infection, but virual NGU also doesn't cause the pattern of symptoms you describe. There is no form of bacterial NGU that would not either respond to the antibiotics you received. So I doubt very much you caught any STD or any infection at all from the oral sex event. More likely it's just a flare-up of your prostatis.
To the specific questions:
1) I disagree. I believe this had nothing to do with the oral sex event. NGU from oral bacteria probably occurs, but the symptoms aren't right, as discussed above.
2) The Japanese study is not the final word about whether M. genitalium can infect the throat and at this point it simply isn't known whether MG can be acquired by fellatio. In any case, MG isn't a plausible cause of your symptoms.
3) Gonorrhea isn't a likely cause, and in any case would have been eradicated by the treatments you received. It's too late to be tested for it.
4) Moxifloxacin indeed is believed to be active against MG.
5) As I said above, your prostatitis is a far more likely cause of all this than any STD.
6) Your SO probably didn't need treatment at all and certainly doesn't need any more treatment. No distant expert can guarantee someone isn't infected. But if I were in your situation, knowing what I know, I would not have treated my wife with antibiotics and certainly at this point I would comfortably continue unprotected sex without fear for her health.
Regards-- HHH, MD
The symptoms you describe do not suggest NGU, for which the main symptom is discharge with little or no painful urination. Your symptoms are much more like a bladder or prostate problem, not urethritis. Conceivably you could have had a viral infection, but virual NGU also doesn't cause the pattern of symptoms you describe. There is no form of bacterial NGU that would not either respond to the antibiotics you received. So I doubt very much you caught any STD or any infection at all from the oral sex event. More likely it's just a flare-up of your prostatis.
To the specific questions:
1) I disagree. I believe this had nothing to do with the oral sex event. NGU from oral bacteria probably occurs, but the symptoms aren't right, as discussed above.
2) The Japanese study is not the final word about whether M. genitalium can infect the throat and at this point it simply isn't known whether MG can be acquired by fellatio. In any case, MG isn't a plausible cause of your symptoms.
3) Gonorrhea isn't a likely cause, and in any case would have been eradicated by the treatments you received. It's too late to be tested for it.
4) Moxifloxacin indeed is believed to be active against MG.
5) As I said above, your prostatitis is a far more likely cause of all this than any STD.
6) Your SO probably didn't need treatment at all and certainly doesn't need any more treatment. No distant expert can guarantee someone isn't infected. But if I were in your situation, knowing what I know, I would not have treated my wife with antibiotics and certainly at this point I would comfortably continue unprotected sex without fear for her health.
Regards-- HHH, MD
MEDICAL PROFESSIONAL
I missed that you had urethral WBC, suggesting a component of urethritis. But whether it was acquired during the oral sex event or was recurrence of a chronic, prostate-related problem is hard to tell, and your primary symptoms certainly sound more prostate-related. Scant morning discharge can result from prostatitis or NGU, but if the discharge is clear, it is probably normal pre-ejaculate fluid that often accompanies normal nocternal erections.
If you have NGU, it isn't necessarily due to infection. The causes of persistent or recurrent NGU or prostatitis aren't known, but many (most?) cases probably are not due to infection, but some other kind of inflammation. Neither recurrent NGU nor NGU acquired by oral sex is known to cause any harm to sex partners, and treatment of infected persons' partners is not known to have any benefit for their health. It is routinely done as a precaution, but nobody knows whether it really is necessary. In any case, after the treatments you have had, you can safely assume that any infectious agent initially present now is gone.
If your symptoms continue, it would be smart to see a urologist, if you have not yet done so. But don't worry about any serious impact on your health. Recurrent problems like this are not known to lead to anything dangerous either in affected men or their sex partners.
My final advice is that if and when you have sex outside your SO partnership, use condoms -- even for oral sex. Then you will never be in the position of worrying about whether recurrence of your probable prostate problem is in fact an STD.
If you have NGU, it isn't necessarily due to infection. The causes of persistent or recurrent NGU or prostatitis aren't known, but many (most?) cases probably are not due to infection, but some other kind of inflammation. Neither recurrent NGU nor NGU acquired by oral sex is known to cause any harm to sex partners, and treatment of infected persons' partners is not known to have any benefit for their health. It is routinely done as a precaution, but nobody knows whether it really is necessary. In any case, after the treatments you have had, you can safely assume that any infectious agent initially present now is gone.
If your symptoms continue, it would be smart to see a urologist, if you have not yet done so. But don't worry about any serious impact on your health. Recurrent problems like this are not known to lead to anything dangerous either in affected men or their sex partners.
My final advice is that if and when you have sex outside your SO partnership, use condoms -- even for oral sex. Then you will never be in the position of worrying about whether recurrence of your probable prostate problem is in fact an STD.
Thank you for your response Dr, I appreciate you giving me some reassurance.
Some last points of clarification:
1. I thought "White cells" in a swab test indicated NGU, when clam is neg. I guess I am simply confused. Can white cells simply mean inflammation, and no infection?
2. I was in fact having a scant amount of discharge upon expression, mostly upon waking. Is this pre-seminal fluid or suggestive of inflammatory response.
3. Even in the event I was infected, what was the risk I passed on something to my SO?
Thank you again, and I will not continue with anymore questions.
Some last points of clarification:
1. I thought "White cells" in a swab test indicated NGU, when clam is neg. I guess I am simply confused. Can white cells simply mean inflammation, and no infection?
2. I was in fact having a scant amount of discharge upon expression, mostly upon waking. Is this pre-seminal fluid or suggestive of inflammatory response.
3. Even in the event I was infected, what was the risk I passed on something to my SO?
Thank you again, and I will not continue with anymore questions.
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